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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 7 of 7. This is the beginning of the thread.
Posted by rfs on September 2, 2006, at 14:48:21
Hi had been taking Effexor for about 19 years. (300mg.) I seemed to be in a state of limbo, My Pdoc wanted me to discontinue effexor and try Emsam. I couldn't stop the effexor no matter what I did. So he increased my doseage to 450mg. I always thought 300mg was the max. In any case I am feeling much better since upping the dose. Has anyone taken this high a dose. I lost a pound or 2 and my ED has improved.
RFS
Posted by SLS on September 2, 2006, at 17:06:34
In reply to Effexor Doseage, posted by rfs on September 2, 2006, at 14:48:21
> Hi had been taking Effexor for about 19 years. (300mg.) I seemed to be in a state of limbo, My Pdoc wanted me to discontinue effexor and try Emsam. I couldn't stop the effexor no matter what I did. So he increased my doseage to 450mg. I always thought 300mg was the max. In any case I am feeling much better since upping the dose. Has anyone taken this high a dose. I lost a pound or 2 and my ED has improved.
> RFS
It is not unheard of for people to take as much as 600mg.
- Scott
Posted by Galennt on September 2, 2006, at 20:45:14
In reply to Re: Effexor Doseage, posted by SLS on September 2, 2006, at 17:06:34
Hi,
Actually, it has been known for somebody to go as high as 1,200 mgs per day of Effexor. I began at 225 12 years ago and over the last 8 years have gradually increased my dosage (under a PDoc's watchful eye). I reached 1,200 about three years ago. I have tried repeatedly to reduce my dose, but even several weeks at 900 resulted in a serious relapse. In fact, even at 1,200 I experience breakthrough depression but have just learned to live with it.
The only other medication that worked for me was Parnate but it caused marked blood pressure elevations. So here I am at 1,200 mgs of Effexor, and relatively free of side effects.
But I assume that at some point even 1,200 will "poop out" entirely. At that point perhaps I'll go back to Parnate and tackle the blood pressure problem, or try Nardil.
Galen
Posted by Jota on September 3, 2006, at 9:21:33
In reply to Re: Effexor Doseage, posted by Galennt on September 2, 2006, at 20:45:14
Why not add an adjucant rather than switching. I took Effexor with great success for many years, like you gradually increasing dose. In retrospect, it was probably a mistake to switch off of it. If I could do it again, I would have added Lamictal and, possibly, Carbatrol (similar to Tegretol). If not effective, I would then add Abilify or Geodon.
When I did switch, it was to Paxil, which worked wonderfully, but only for about 2 years.
Right now I find myself on a horribly complicated combo based on Lexapro, Straterra, Wellbutrin, Carbatrol, Lamictal, Abilify, cytomel, folic acid, fish oil. And still break through! My next move may be to swap Geodon for Abilify.
Posted by Galennt on September 3, 2006, at 13:42:01
In reply to Re: Effexor Doseage, posted by Jota on September 3, 2006, at 9:21:33
> Why not add an adjucant rather than switching. I took Effexor with great success for many years, like you gradually increasing dose. In retrospect, it was probably a mistake to switch off of it. If I could do it again, I would have added Lamictal and, possibly, Carbatrol (similar to Tegretol). If not effective, I would then add Abilify or Geodon.
> When I did switch, it was to Paxil, which worked wonderfully, but only for about 2 years.
>
> Right now I find myself on a horribly complicated combo based on Lexapro, Straterra, Wellbutrin, Carbatrol, Lamictal, Abilify, cytomel, folic acid, fish oil. And still break through! My next move may be to swap Geodon for Abilify.Hi,
I forgot to mention that I do augment with Wellbutrin and fish oil. I had not thought of throwing something else in the mix, but I guess I should.
gt
Posted by rfs on September 4, 2006, at 8:03:53
In reply to Re: Effexor Doseage, posted by Galennt on September 3, 2006, at 13:42:01
> > Why not add an adjucant rather than switching. I took Effexor with great success for many years, like you gradually increasing dose. In retrospect, it was probably a mistake to switch off of it. If I could do it again, I would have added Lamictal and, possibly, Carbatrol (similar to Tegretol). If not effective, I would then add Abilify or Geodon.
>
> > When I did switch, it was to Paxil, which worked wonderfully, but only for about 2 years.
> >
> > Right now I find myself on a horribly complicated combo based on Lexapro, Straterra, Wellbutrin, Carbatrol, Lamictal, Abilify, cytomel, folic acid, fish oil. And still break through! My next move may be to swap Geodon for Abilify.
>
> Hi,
>
> I forgot to mention that I do augment with Wellbutrin and fish oil. I had not thought of throwing something else in the mix, but I guess I should.
>
> Hi
I am now taking the 450 mg of effexor. I see the Pdoc on 9/12. I would like to go higher. Would that be a reasonale request or will he think, it is out of the question.
> I also take klonopin as needed. I am not sure yet but I seem to be taking it more often. Is that because of the stimulating effect of the effexor. Also,In the past, I have taken wellbutrin with effexor, but only got a slight benefit.
Regarding the Klonopin, although I don't take it every day, and don't increase the doseage, and never notice any impairment, Since it has a long half life, I might be addicted/dependent?. That doesn't bother me as long as I don't have to take more and more. Would anyone reading this agree or disagree. or have any suggestion on how to reduce anxiety without benzos. I have tried most A/D some better for anxiety, but nothing compares to benzos. I guess I have been taking it for close to a year now.
Last thing I guess you all know that I hit the wrong key when I wrote 19 years,(impossible, since I think effexor came out about 12-13 years ago) I meant 10 years.
Ray
Posted by Galennt on September 7, 2006, at 16:53:16
In reply to Re: Effexor Doseage, posted by rfs on September 4, 2006, at 8:03:53
RFS- I have encountered two sorts of psychiatrists. The larger group is tied to the maximum doses stipulated by the DSM. Wyeth, the maker of Effexor acknowledges that its trials have not looked at doses above 375 mgs. The PDR suggests that 375 is the highest dose demonstrated to be effective.
The second, smaller group of pdocs knows that medications react differently in each individual and that the pre-release clinical trials tested only for 12 week spans of time. Wyeth has conducted post-release trials that have demonstrated Effexor's utility over longer periods of time, up to,I believe, one year. But nobody, to my knowledge, has proved or disproven the efficacy of Effexor at doses of 400 mgs. and higher. Nor have they addressed the issue of whether 500 mgs or more can help a person who remains depressed at 375.
I have found physicians who are not wedded to the PDR to be flexible with patients, especially those who are informed about meds and can make a case for their unorthodox Tx needs.]
gt
This is the end of the thread.
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